The Best Chiropractic Care in Mesa, Arizona
by James Bogash
Effectiveness of an Intervention Program in the Prevention of Asthma
This is one of those rare articles in the mainstream medical journals that makes some very rational suggestions for preventing the onset of asthma in infants. Now, add to their recommendations the avoidance of common allergens such as milk and corn and the addition of probiotics to keep the immune system in balance, and I think the results of this study would be even more positive.
by James Bogash
Increased Physical Activity Tied to Asthma in Children
Man, it sure is “debunk preventative medicine” day! Once again we have an article that suggests that an activity previously thought of as a good thing may have some negative aspects. Something to remember before you run out to stop your child from playing hard…high levels of physical activity will increase metabolism and increase the demand for antioxidants. With today’s child eating a diet very low in certain antioxidants, an increase in activity is a prescription for chronic disease… 57th Annual Meeting of the American Academy of Allergy, Asthma and Immunology Overall, 9.1% of white children and 12.5% of black children had asthma diagnoses. The researchers found that yearly physical activity was significantly higher in asthmatic than non-asthmatic children. Multivariate analysis adjusting for race, gender, birth weight, body mass index, percent body fat, and physical activity revealed that only physical activity was significantly related to the prevalence of asthma. However, separate analysis for each race failed to identify a significant association in black children. “There has been concern brewing about the increasing prevalence of asthma in children in this country,” Dr. Ownby noted in an interview with Reuters Health. One theory, he said, “had been that because children weren’t playing as hard as they used to, they weren’t expanding their lungs as much and thus they were at a higher risk of developing asthma.” However, “we found just the opposite was true,” he said. Dr. Ownby’s team used metabolic equivalents (mets) to quantify the various levels of physical activity. One met was equal to sitting quietly. Standardizing physical activity “allowed us to compare judo class with soccer practice or ballet,” Dr. Ownby explained. “I think this study will stir up some controversy because several people have been preaching [the conventional wisdom] based on pretty shaky data or data extrapolated from other countries,” Dr. Ownby noted. “As far as we know, our study is one of the most detailed studies investigating this issue in the United States.” Dr. Ownby believes that a “diagnostic bias” may explain the current findings. “The children who are more physically active may be more likely to have the symptoms of asthma and therefore be more likely to get diagnosed,” he said.
by James Bogash
Breastfeeding Linked to Increased Risk of Atopy and Asthma
This is one of those articles that the media will love to use to try to scare the heck out of mothers. However, much like the vitamin C research that shows an increase in DNA damage (further delving revealed that vitamin C also protects against more severe and damaging types of DNA damage…) one study does not set the standard in stone. While I can’t think of a rationale as to why the use of a therapy deemed highly beneficial would show a negative relationship. It would be interesting to evaluate the diets of the mothers for potential allergens that the infant would be exposed to…
57th Annual Meeting of the American Academy of Allergy, Asthma and Immunology Dr. Malcolm R. Sears from McMaster University in Hamilton, Canada and colleagues assessed the impact of breastfeeding on the development of atopy and asthma by comparing data on 504 subjects who were breastfed for at least 4 weeks with data on 533 subjects who were not. Skin testing at age 13 revealed that breastfed subjects were significantly more likely than their counterparts to have a positive reaction to cat, dust mite, or any tested allergen. In fact, this effect was evident on repeat testing at age 21 years. In addition, breastfed subjects were more than twice as likely as their cohorts to have been diagnosed with asthma by 9 years of age. The effects of breastfeeding seen at 13 years of age were independent of maternal or paternal history of atopic disease, first born or non-first born status, and gender, the researchers note. However, at age 21 years the effects were most evident and significant in male subjects. “The majority of review papers and advice given says breastfeeding is good because it reduces your risk of developing allergy and asthma,” Dr. Sears told Reuters Health. “However, the evidence is mixed and our study, which analyzes a New Zealand cohort, found just the opposite effect,” he said. “Our study differs from previous studies in that the prior studies were short term and often looked at early childhood wheezing which often is not allergic-based,” Dr. Sears pointed out. “We know that breastfeeding reduces the likelihood of infection; therefore it may have improved the outcome for infection-based wheezing,” he explained.
by James Bogash
Could TH1 and TH2 diseases coexist?
This is a concept that can shake many of our foundations. TH1 immune response is the “killer attack dog” system, while the TH2 is the “killer guard dog” system. TH2 keeps things (bacteria, viruses…) out while TH1 destroys them if they manage to get through. Too much TH1 leads to autoimmune prevalence; too much TH2 leads to allergies and asthma as the immune system overreacts to things trying to get in. Much current thinking does not allow imbalances in the TH1/2 response to coexist–it’s an either or response. However, this concept is beginning to be shattered. We already know that as we age our immune system is less responsive, and yet incidence of autoimmune antibodies increases as we get older. This seems paradoxical, and yet it indicates a dis-regulation in the immune response. The presence of both TH1 and TH2 over-response coexisting is still a new concept and keep yourself open for future theory and research.
Journal of Allergy and Clinical Immunology Online
by James Bogash
Early Respiratory Infections and Childhood Asthma
Several previous studies have suggested that infections early in life may protect against asthma. This study contradicts previous findings, and even goes further to conclude that early infections increase the risk of asthma. I have a feeling that we are going to see this issue bounced back and forth for the next several years. There are some things to consider with the results of this study. The author does not mention how those early infections were treated. Previous studies have identified a link between childhood antibiotic use and asthma. If a majority of these children were treated with antibiotics for their infections, this may be where the link lies and not with the infection itself. I truly believe that childhood infections that are allowed to “run their course” helps to strengthen an infants’ health.
by James Bogash
Prevalence of atopic disorders in children with chronic OME
Here’s a hypothesis for these findings–children with chronic otitis media w/ effusion (sterile fluid in the middle ear) have very likely gone through many courses of antibiotics. We have discussed very frequently how important normal, healthy flora in the GI tract is protective. Destroy this w/ antibiotics and chronic diseases such as allergies and asthma begin to pop up…
Synergy : Pediatric Allergy and Immunology 12 (2), 102-106
by James Bogash
Allergy Reports of Dubious Value in Pediatric Asthma
In my opinion, the authors of this article have it all backwards. They compare the parents’ and childrens’ report of allergies to skin prick testing and found poor correlation. This is not surprising since skin prick testing looks for immediate onset allergy, and I believe that this is not the major contributor to chronic diseases. The delayed type hypersensitivity appears to be much more practical of a measure of sensitivities to foods and environmental influences. I have run IgG4 tests on patients that have almost no reaction in the immediate onset category and yet show a delayed hypersensitivity to almost all items tested.
J Asthma 2000;37:685-690 Reports of allergies by young asthma patients and their parents are “no better than chance” in predicting reaction to skin tests for common allergens, according to findings published in a recent issue of the Journal of Asthma. Despite a well-documented association between allergy and asthma, “little is known concerning how well allergy history actually agrees with skin testing,” Dr. Edward R. Carter and colleagues, from Madigan Army Medical Center, Tacoma, Washington, explain. To investigate, the researchers studied 95 children, aged 4 to 18 years, with physician-documented asthma. Parents and children answered a series of questions on allergy history. The children then underwent skin testing for allergy to cat, dust mite and grass. Comparison of allergy history and skin test reactivity showed that reports had a 65% diagnostic accuracy in identifying allergy to cat. Corresponding figures for dust mite and grass were 50% and 56%. Outcome was not affected by the severity of asthma. Given the poor predictive performance of such reports, Dr. Carter told Reuters Health that “a patient’s allergy history does not predict skin test reactivity, and, thus, one should not base allergy control measures for patients with asthma on skin test results or allergy history alone.” Furthermore, he added that the findings emphasize “the need of performing formal allergy testing…and combining this with allergy history and asthma severity to come up with an individualized plan for allergy control measures in each patient with asthma.”
by James Bogash
In Utero And Perinatal Factors May Influence Asthma Risk in Children
There are many people who want to blame genetics for much of today’s chronic diseases, but I firmly believe that environment is the bigger player. As more and more studies come out implicating factors at the beginning of life in health, I feel confident that my viewpoint will become even more cemented.
Allergy 2001;56:491-497 Complications during pregnancy or delivery, illness during the first week of life and low birthweight appear to be associated with an increased risk of childhood asthma. To establish whether there is a link between asthma and events in pregnancy and early life, Dr. Isabella Annesi-Maesano from INSERM in Villejuif, France and colleagues collected data on 4065 children of 2583 mothers from the National Child Development Stud. The children, who were born in 1958, were followed into adulthood and were last interviewed in 1991, according to the report in the June issue of Allergy. Childhood asthma developed in 10.1% of the cohort. Overall, asthma was more common among children with mothers who had complications during pregnancy. The researchers also found higher rates of asthma in subjects with illness or health complications during the first week of life and birthweights below 2.5 kg. Early or threatened labor and the malposition or malpresentation of the fetus were significantly related to the development of childhood asthma, Dr. Annesi-Maesano’s team reports. “These findings among the offspring of a nationally representative birth cohort obtained after controlling for potential confounders provide further epidemiologic evidence that the risk of developing childhood asthma may be influenced to some extent by events in pregnancy and delivery,” Dr. Annesi-Maesano and colleagues conclude.
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